Alcohol policy in the Netherlands

The problem
Alcohol use by young people, especially binge drinking, is an increasingly big problem in the Netherlands. A recent report estimated that the number of alcohol poisonings in young people between 10 and 19 years is more or less 560 per year. Thus, an average of one to two adolescents with alcohol poisoning is committed to a hospital each day. Especially within the age group of 10 to 14 years, a worrying increase in the number of alcohol poisonings is visible: between 2000 and 2005 this number has six folded.

Effective measures
Thus far, the Dutch government has been hesitant to enforce measures that have shown to be effective in curbing underage drinking. One can think about restricting the availability of alcohol in supermarkets, raising the age limit from 16 to 18, a better adherence to the age limits, a ban on alcohol advertising, a tax raise and informing parents about the damaging effects of alcohol to their underage children. 

Alcohol lobby
The alcohol industry has a strong lobby and has thus far been successful in diverting attention away from these successful measures. The focus the past years to ‘tackle’ the alcohol problem in young people, has been on educational health campaigns. As we know from research, this strategy is effective in raising awareness for the problem, but most of the time does not lead to a change in behaviour, in this case a decrease in alcohol use.

Direction of the new Dutch cabinet
It seems a shift is taking place: the Ministry of Public Health, Welfare and Sports will offer an alcohol policy advice for the next few years to several Ministers in the next few weeks. It will contain a ‘package’ of measures to curb underage drinking. Focus will be on restricting alcohol advertising, increasing taxes, increased inspection of adherence to the age limits and limiting alcohol availability.

Alcohol advertising
At this point the new Dutch cabinet has proposed a partial time ban on alcohol advertising on radio and television between 6.00 and 21.00 hours. Hopefully, this proposal will be approved of and subsequently embedded in national law (the Alcohol Licensing and Catering Act or Drank- en Horecatwet) and not in self-regulation. The Netherlands is one of the few European countries that has no rules for alcohol marketing and advertising embedded in statutory regulation. Only the 31 rules embedded in self-regulation limit the content of alcohol advertising, but hardly the volume. STAP monitors the content of alcohol advertising by comparing ads to the Alcohol Advertising Code. If a breach of the Code seems to have occurred, STAP files a complaint with the Advertising Code Committee. Many Dutch pubs (1 out of 3) make use of alcohol advertising by offering cheap drinks, e.g. on outdoor displays. Thus far, the local authorities hardly have any measures to prevent the pubs from offering price discounts. It has been proposed to provide them with more possibilities to do this by extending the Alcohol Licensing and Catering Act.

Taxes
A tax increase has recently been proposed as well. The government will receive 200 million extra euros from tax increase on alcohol and tobacco. However, the suggested increase on wine and beer is that low, that it cannot be expected to have the intended effect on alcohol consumption. The tax on a bottle of beer will increase with €0,02 (from €0,09 to €0,11). On average, a bottle of beer now costs €0,40; after the tax raise it will be €0,42. Thus, a case of beer containing 24 bottles becomes almost half a euro more expensive. The tax on a bottle of wine will increase with €0,05 (from €0,41 to €0,46). The consumer will not actually feel these suggested tax increases, which will, most probably, not lead to a decrease in consumption.

Age limits and adherence
At this point, two age limits exist in the Netherlands: 16 years for beverages with low alcoholic content (< 15%) and 18 years for spirits. The Ministry of Public Health, Welfare and Sports might suggest a decentralized regulation of age limits. Thus, they want to give the local authorities the possibility to choose between raising the limit to 18 years for all alcoholic beverages or keeping two limits of 16 and 18. Disadvantages of this decentralized regulation are an increased risk of traffic accidents in which alcohol is involved (since young people will move to areas where they are allowed to drink at 16), increased confusion for the inspectors that have to monitor adherence to the age limits, and an unfair competition between the neighbouring pubs from different municipalities. A national raise of the minimum age to 18 would be the best solution and has been shown to be effective. Local authorities and police will be given more power to monitor adherence to the age limits by the alcohol provider (e.g. supermarket, liquor stores, pubs).

Licence/permit for alcohol sales in supermarkets
Liquor stores in the Netherlands are obliged to have a licence/permit, to sell alcohol. Thus far, supermarkets can sell alcohol without such a permit. It has been suggested to introduce a licence system for supermarkets as well. If they do sell alcohol to minors, they run the risk of high fines. After several violations of the law, the permit should be withdrawn, which means they are not allowed to sell alcohol anymore. These strong sanctions will increase the chances of supermarkets adhering to the age limit of 16 years. Now, 9 out of 10 minors succeed in buying alcohol at a supermarket. 

Limit the availability of alcohol
The Ministry of Public Health, Welfare and Sports has suggested removing all alcopops and other sweet alcoholic beverages from the supermarket because they are specifically attractive to young people (sales of alcopops would then only be allowed in liquor stores). However, removing only sweet alcoholic beverages from the supermarket is in conflict with European law, that states that the sales of a national product (e.g. Heineken beer) cannot harm the sales of an import product (e.g. Bacardi breezer). Increasing the tax on alcopops would be another solution to decrease the attractiveness of this product by young people. In Germany, Bacardi removed the Breezers from the market because a tax raise led to decreased sales.

Penalization of minors ‘in possession’ of alcohol in public places
A Dutch political party has proposed that minors should be penalized when they are in the possession of alcoholic beverages when under the age of 16, in public areas. STAP is, in the first instance, not very supportive of this measure because we believe the alcohol problem in young people has been created by adults and should in the first place also be solved by adults. Punishing minors for the possession of alcohol might be a measure that can be deployed if other suggested measures do not succeed sufficiently in curbing underage drinking.

Focus on the parents
Since 2007  the Trimbos Institute in the Netherlands has been trying to educate parents on the topic of alcohol in minors. The message of the health campaign is: “Prevent alcohol damage in your growing child”. Parents in the Netherlands do not seem to be very much aware of the damage that alcohol can do to the developing brain and body. Often, parents buy alcohol for their children, and let them drink at home or in ‘Hokken en Keten (cabins)’. Also, research shows that parents usually underestimate the alcohol consumption of their children. Therefore, an increase in awareness of this topic is at place.

Labelling and International FAS Day
In the first week of September, unfortunately, the European Parliament voted against health warning labels on alcoholic beverages. STAP believes this is a missed opportunity to increase the awareness of the effects of alcohol use during pregnancy. In the Netherlands, more or less 50% of pregnant women drink regularly. There is too little awareness that even small dosages of alcohol can lead to damage which can manifest itself later in life through e.g. hyperactivity and social problems. Also, Fetal Alcohol Syndrome (FAS) is not commonly known by people.

The FAS Foundation participated in the International FAS Day, held on September 9th, and tried to bring the topic “9 months pregnant, 9 months alcohol-free” under the attention to the public. A special website was launched and they were successful in bringing their message forward in the media.

Local alcohol policy in the mood
In the Netherlands there is an increasing focus on effective regional and local alcohol policy. Influenced by international research results the local approach is more and more based on three elements: public support (key-words: promoting awareness, media advocacy etc), effective regulations (main target: restricting availability) and improving enforcement (for years the weakest element of local alcohol policy). STAP is playing a active role in this process. The new approach means: a more important role for controllers and police officers, a leading management role for municipalities, and a more modest role for interventions based on education. Local alcohol policy is for years dominated by the educational approach and elements like restricting availability and effective enforcement are verwaarloosd.      

STAP
Utrecht, September 12th, 2007